patient load

[Guest guest]

After 5 years, I'm revisiting the question of what type of

practice to have: specifically, numbers of patients seen per

hour and quality of care. I know many acups see 2 or more

people per hour. I would like to hear from anyone who does

this who is able to include herbal prescribing (custom?) and

modalities such as moxa and cupping. How do you do it? What

are the logistics? I think one knowledgeable assistant who

doubled as a receptionist (and cash-only or add a medical

biller) would be necessary and sufficient to achieve all

that. The practices I know of that have overlapping patients

are acupuncture only, no modalities where the practitioner

needs to be present, and patents only. I've seen the most

experienced/best herbalists write complex custom formulas in

2 minutes but I'm a long way from that. I know the financial

picture is rosier when you 'pack 'em in' but the type of

care seems to have to be limited. Have any of you delved

into these issues and since come to a happy resolution you'd

like to share?

 

Marian

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[Guest guest]

, " Marian Blum "

<marianb@r...> wrote:

>

> people per hour. I would like to hear from anyone who does

> this who is able to include herbal prescribing (custom?) and

> modalities such as moxa and cupping. How do you do it? What

> are the logistics? I think one knowledgeable assistant who

 

In the Practice Management class at PCOM taught by Marilyn Allen, it

is recommended that herbal prescribing take place in an appointment

all by itself. IMO, this is ideal for the practitioner, but less so

for the patient.

 

Marilyn futher states that the way we treat as interns in the clinic

(squeezing everything possible modality, including herbs, into a 60

minute time period) is not a realistic model for a profitable

practice. Also, this type of practice does not happen with any other

type of healthcare provider.

 

Again, this advice weighs in favor of the practitioner and not the

patient.

 

Brian C. Allen

[Guest guest]

How do you do it?

>>>Have several treatment rooms

alon

 

 

[Guest guest]

I am definitely struggling with this issue. So far I have asked my

patients to come back and pick up the formula. I need time to think

about it and then to fill it. Unfortunately I feel like I am

spending so much time with patients that I prescribe herbs for that I

have very little motivation to suggest herbal formulas for my

patients! I can't imagine how many years of practice I would have to

have before I would be good enough for that not to be the reality.

The amount of money that I get in exchange for the herbs just doesn't

seem worth all the work involved. Therefore I am only prescribing

herbs for people if I've tried acupuncture and its not getting the

results that I want and it seems really important that they get herbs-

--or in obvious situations like infertility.

 

Laura

 

 

, " Marian Blum "

<marianb@r...> wrote:

>

> After 5 years, I'm revisiting the question of what type of

> practice to have: specifically, numbers of patients seen per

> hour and quality of care. I know many acups see 2 or more

> people per hour. I would like to hear from anyone who does

> this who is able to include herbal prescribing (custom?) and

> modalities such as moxa and cupping. How do you do it? What

> are the logistics? I think one knowledgeable assistant who

> doubled as a receptionist (and cash-only or add a medical

> biller) would be necessary and sufficient to achieve all

> that. The practices I know of that have overlapping patients

> are acupuncture only, no modalities where the practitioner

> needs to be present, and patents only. I've seen the most

> experienced/best herbalists write complex custom formulas in

> 2 minutes but I'm a long way from that. I know the financial

> picture is rosier when you 'pack 'em in' but the type of

> care seems to have to be limited. Have any of you delved

> into these issues and since come to a happy resolution you'd

> like to share?

>

> Marian

> ---

> Outgoing mail is certified Virus Free.

> Checked by AVG anti-virus system (http://www.grisoft.com).

> Version: 6.0.734 / Virus Database: 488 - Release Date:

> 08/04/2004

[Guest guest]

, " Marian Blum "

<marianb@r...> wrote:

>

> After 5 years, I'm revisiting the question of what type of

> practice to have: specifically, numbers of patients seen per

> hour and quality of care. I know many acups see 2 or more

> people per hour. I would like to hear from anyone who does

> this who is able to include herbal prescribing (custom?) and

> modalities such as moxa and cupping. How do you do it? What

> are the logistics? I

.. Have any of you delved

> into these issues and since come to a happy resolution you'd

> like to share?

>

> Marian

 

 

Marian,

I also have been in practice for five years. I work in a multi-

disciplinary clinic (we have 9 practioners) where I have one room

that is mine all the time and I share another room 1 1/2 days a

week. This way I don't have to pay rent when I am not using the

room. Usually I can get caught up with refills on the single room

days. When it is not my doubled day and a half I can fill the

formula(granules) easily. I also can manage to get out formulas

usually on the doubled day because I haven't trained every patient

to take herbs yet. But sometimes patients just have to pick them up

the next day. They usually don't mind.

It would be helpful if my pharmacy was closer to my rooms. I have to

run up and down the stairs many times a day but I suppose it saves

on gym fees.

Our office does have a wonderful office manager that makes sure I

get the notes about so and so needs herbs etc. She also collects the

$ and gives patients reciepts and books appointments.

Occasionally it gets a little crazy and I have to stay late or get

in early but I make up for this by being strict on my rule of only

working four days a week, and an hour and a half lunch break. But I

really like having at least some doubled days. I'm not sure I'd

want to do it all the time. And yes, I do moxa, cupping and gua sha

as needed.

I also take insurance clients so I have a biller that picks up the

superbills and attends to all the follow-up and phone calls. I tried

to do it myself(for a year and a half) but I was working to hard at

things I don't enjoy.

 

In our town each practitioner has their own pharmacy.

What do you and others think about having pharmacies(like chinatowns

in larger cities) instead of each practitioner having their own?

 

Jill Likkel

[Guest guest]

, " Marian Blum "

<marianb@r...> wrote:

>

> After 5 years, I'm revisiting the question of what type of

> practice to have: specifically, numbers of patients seen per

> hour and quality of care. I know many acups see 2 or more

> people per hour. I would like to hear from anyone who does

> this who is able to include herbal prescribing (custom?) and

> modalities such as moxa and cupping. How do you do it? What

> are the logistics? I think one knowledgeable assistant who

> doubled as a receptionist (and cash-only or add a medical

> biller) would be necessary and sufficient to achieve all

> that. The practices I know of that have overlapping patients

> are acupuncture only, no modalities where the practitioner

> needs to be present, and patents only. I've seen the most

> experienced/best herbalists write complex custom formulas in

> 2 minutes but I'm a long way from that. I know the financial

> picture is rosier when you 'pack 'em in' but the type of

> care seems to have to be limited. Have any of you delved

> into these issues and since come to a happy resolution you'd

> like to share?

>

> Marian

 

Hi Marian:

In my clinic, I have seen 4 people an hour for close to twenty years.

As of one year ago, I have hired a co-practitioner and we see 4 to 6

per hour.

We use all modalities of chinese medicine--acupuncture, moxa,

cupping, massage,

loose herbs, pill herbs, nutritional consults and develop treatment

plans which are

often for use with Western and other referring practitioners.

In my experience, one needs a good front office person who can handle

the money

and phone calls and appointments and enter non-insurance client info

into the

computer for accounting purposes, learn to do inventory, ordering and

receiving of

herbs, needles and all supplies. We also have assistants, most often

massage

therapists and acupuncture students who want experience in a

full-service Chinese

medicine clinic. They can do massage, prepare rooms, take clients to

rooms, learn to

dispense loose herb formulas (under supervision), do filing and other

things

necessary to run the clinic.

All of the staff, including myself and practitioners, can run the

front desk and do

everything in the clinic--cross-training is very important.

And, as Alon says, you need enough treatment rooms/spaces to make it

all happen.

Our front office is also our herb room--we carry many pill herbs and

have about 550

loose herbs in stock--so the herb dispensing area is right at the

front desk, This

nade it easy to cross-train the front desk people and the assistants

to put together

herb formulas.

I hope this is somewhat helpful.

Yours, Misha